Bill summaries are authored by CRS.

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Reported to Senate amended (09/19/2006)

Older Americans Act Amendments of 2006 - (Sec. 2) Reauthorizes the Older Americans Act of 1965.

Revises the definition of "information and assistance service" to include such a service for older individuals at risk for institutional placement.

(Sec. 3) Authorizes the Assistant Secretary for Aging to establish or designate within the Administration on Aging (AoA) an Office of Elder Abuse Prevention and Services. Assigns to the Assistant Secretary the duty of developing objectives, priorities, policy, and a plan for: (1) carrying out elder justice programs; (2) collecting and disseminating data relating to the abuse, neglect, and exploitation of older individuals (abuse); (3) disseminating information concerning best practices regarding, and providing training on, activities related to such abuse; (4) researching such abuse; (5) providing technical assistance to states and other entities; and (6) studying the national incidence and prevalence of such abuse.

Authorizes the Assistant Secretary to designate an officer to be responsible for the administration of mental health services authorized under this Act. Establishes the duty of the Assistant Secretary to develop objectives, priorities, and a long-term plan for supporting state and local efforts involving education, prevention, detection, and treatment of mental disorders, including age-related dementia, depression, and Alzheimer's disease and related neurological disorders.

(Sec. 4) Adds functions of the AoA concerning: (1) coordinating activities to implement and build awareness of programs for older individuals; (2) providing technical assistance to support efforts to provide information about certain federal public assistance programs; (3) providing support for efforts to inform and enroll older individuals in programs for which they are eligible; (4) implementing procedures for collecting information about services, including long-term care in home and community-based settings; and (5) providing information and technical assistance to support provision of evidence-based disease prevention and health promotion services.

Authorizes the AoA to establish a National Center on Senior Benefits Outreach and Enrollment that shall: (1) maintain and update web-based decision support and enrollment tools and integrated, person-centered systems to inform older individuals about the full range of benefits for which they may be eligible; (2) utilize cost-effective strategies to find and enroll those with greatest economic need; (3) create and support efforts for Aging and Disability Resource Centers and other organizations and coalitions to serve as enrollment benefit centers; (4) develop and maintain an information clearinghouse on best practices and cost-effective methods for identifying and enrolling limited income older Americans in benefits; and (5) provide training and technical assistance on effective outreach, screening, enrollment, and follow-up strategies.

Requires the Assistant Secretary to: (1) coordinate with other federal agencies responsible for formulating and implementing programs, benefits, and services related to providing long-term care; (2) conduct research and demonstration projects to identify strategies for modifying state long-term care systems to respond to the needs of older individuals and family caregivers and to target services to individuals at risk for institutional placement; (3) establish criteria and promote the implementation of evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability; (4) facilitate, in coordination with the Centers for Medicare and Medicaid Services and other federal entities, the provision of long-term care in home and community-based settings, including self-directed care models to help individuals avoid unnecessary nursing home placement and depletion of income and assets to qualify for Medicaid eligibility and to assist older individuals to develop a plan for long-term support; (5) provide for the AoA to play a lead role with respect to issues concerning home and community-based long-term care; (6) promote public awareness of the importance of, and resources available for, planning for long-term care; (7) implement in all states Aging and Disability Resource Centers; (8) establish a national technical assistance program to assist state agencies, area agencies on aging, and community-based service providers that receive funding under this Act in implementing such home and community-based long-term care systems; and (9) develop performance standards and measures for use by states to determine the extent to which their systems of long-term care fulfill objectives of this Act.

Requires the Assistant Secretary to: (1) encourage and permit voluntary groups active in supportive services and civic engagement to participate in such programs or activities; (2) develop a comprehensive strategy for utilizing older individuals to address critical local needs of national concern; and (3) encourage other community capacity building initiatives involving older individuals.

(Sec. 5) Requires the Secretary, in collaboration with the Secretary of Housing and Urban Development and specified federal officials, to establish an interagency coordinating committee for aging issues. Requires the Committee to: (1) review and make recommendations concerning programs that assist older individuals; and (2) annually report to the President and Congress on its activities, the level of federal assistance needed, and barriers and impediments to the use of such services by older individuals. Requires the Secretary of Health and Human Services to appoint a committee executive director.

(Sec. 6) Repeals the authorization for the Assistant Secretary to provide staff and assistance to the Federal Council on the Aging.

Adds as duties of the officer responsible for the administration of nutrition services to: (1) design, implement, and evaluate evidence-based programs to support improved nutrition and regular physical activity for older individuals; (2) conduct outreach and disseminate evidence-based information to nutrition service providers about the benefits of healthful diets and regular physical activity; (3) disseminate guidance that describes strategies for improving the nutritional quality of provided meals; and (4) provide technical assistance to the AoA's regional offices.

(Sec. 10) Requires the Assistant Secretary to conduct outreach and provide technical assistance to entities that serve older individuals in integrated health promotion and disease prevention programs that include nutrition education, physical activity, and other activities to modify behavior and to improve health literacy.

(Sec. 11) Revises requirements for pension counseling and information grant applications to include older individuals with limited English proficiency among those given particular emphasis in an outreach plan concerning retirement benefits.

(Sec. 12) Authorizes appropriations for: (1) AoA's administration salaries and expenses; (2) family caregiver support; (3) the Eldercare Locator Service; (4) pension counseling and information programs; (5) supportive services; (6) congregate nutrition services; (7) home delivered nutrition services; and (8) disease prevention and health promotion services for FY2007-FY2011.

(Sec. 15) Provides that: (1) an additional 1% of state allotments may be used by area agencies on aging to carry out activities regarding assessment of the needs of the growing elderly population; and (2) such amount may not exceed 10% of state allotments.

(Sec. 16) Includes among state eligibility requirements for grants for programs on aging assurance a requirement that preference be given to providing services to older individuals with limited English proficiency. Revises requirements for state grant applications to include the promotion of the development and implementation of a comprehensive, coordinated system for providing long-term care in home and community-based settings by: (1) coordinating with other state agencies; (2) participating in any state government activities concerning long-term care; (3) conducting analyses and making recommendations with respect to strategies for modifying the state system for long-term care; and (4) providing information on the need to plan for long-term care and the range of available long-term care resources.

(Sec. 17) Requires area plans to: (1) determine the extent of need for supportive services, nutrition services, and multipurpose senior centers by considering the number of older individuals with low incomes residing in such area, the number at risk for institutional placement, and the number who have greatest economic need; (2) provide assurance that the area agency on aging will set objectives for providing services to older individuals with greatest economic need, greatest social need, and at risk for institutional placement; (3) include specific objectives for providing services to low-income minority, limited English proficiency, and rural elderly; (4) include methods to achieve specific service objectives; (5) emphasize in outreach efforts older individuals at risk for institutional placement; (6) provide assurance that the area agency on aging will coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities;(7) provide that the area agency will make use of trained volunteers in providing services and work in coordination with volunteer programs designed to provide benefits for volunteers in community service settings; (8) provide that the area agency will include family caregivers, service providers, and the business community on its advisory council; and (9) increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, and coordinate mental health services provided with funds expended by the area agency on aging with mental health services provided by community health centers and by other public agencies and nonprofit private organizations.

Requires area plans to provide that the area agency on aging shall facilitate the area-wide development and implementation of a comprehensive, coordinated system to provide long-term care in home and community-based settings in a manner responsive to the needs and preferences of older individuals and their family caregivers.

Requires area plans to provide: (1) assurances that funds received will be used in a manner that gives priority in furnishing benefits and services to older individuals with greatest economic need, greatest social need, and at risk for institutional placement; and (2) the furnishing of services under this Act consistent with self-directed care. Requires agencies to: (1) include in each such plan an assessment of how prepared the planning and service area is for a change in the number of older individuals during the next 10 years; and (2) make recommendations to government officials regarding actions by the area agency to build the area's capacity to meet the needs of older individuals for health and human services, land use, housing, transportation, public safety, workforce and economic development, recreation, education, civic engagement, and other services.

(Sec. 18) Requires state plans to provide that the state agency will conduct evaluations of the effectiveness of services provided to individuals with greatest economic need, greatest social need, or disabilities, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas. Requires the plan, with respect to the preceding fiscal year, to: (1) identify the number of low-income minority older individuals in the state, including the number with limited English proficiency; and (2) describe the methods used to satisfy the service needs of such individuals, including individuals with limited English proficiency. Requires the plan to provide assurance that the state agency will require outreach efforts that will identify eligible individuals, with special emphasis on older individuals with greatest economic need and greatest social need, with particular attention to low-income minority individuals, individuals with limited English proficiency, and individuals residing in rural areas.

Requires that each such plan: (1) provide assurances that the area agencies on aging will provide for the furnishing of services under this Act consistent with self-directed care; and (2) include, at the election of the state, an assessment of how prepared the state is, under its service delivery model, for a change in the number of older individuals during the next 10 years. Allows such assessment to include: (1) the projected change in the number of older individuals in the state; (2) an analysis of how such change may affect such individuals; (3) an analysis of how the state programs, policies, and services can be improved, including by coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population; and (4) an analysis of how the change in number of individuals 85 years of age and older is expected to affect the need for supportive services.

(Sec. 20) Authorizes appropriations for FY2007-FY2011 to carry out the nutrition services incentive program.

(Sec. 22) Adds as supportive services that the Assistant Secretary may fund through grants: (1) the provision of assistive technology devices and services to meet the needs of older individuals who are disabled and other individuals who provide uncompensated care to their adult children with disabilities; and (2) services to support states, area agencies on aging, and local service providers in carrying out and coordinating mental health services activities, including outreach, education, screening, and referral for treatment of older individuals,

(Sec. 23) States that the purpose of the nutrition projects grant program is to promote socialization and the health and well-being of older individuals by helping them gain access to nutrition services to delay the onset of adverse health conditions.

(Sec. 24) Includes among nutrition projects for which states may receive grants congregate setting and home-delivered projects that provide nutrition education, nutrition counseling, and other nutrition services.

(Sec. 27) Requires states to: (1) ensure their nutrition projects comply with the most recent Dietary Guidelines for Americans; and (2) encourage joint arrangements with facilities serving meals to children. Requires that such projects: (1) provide nutrition assessment; and (2) encourage professionals who distribute nutrition assistance to provide information to homebound seniors on how to get an influenza vaccination in their local areas.

(Sec. 28) Directs the Assistant Secretary for Aging to use allocated funds to contract with the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences to establish an independent panel of experts to conduct an evidence-based evaluation of nutrition projects. Requires the Assistant Secretary to report to Congress on the panel's evaluation.

(Sec. 29) Requires the Assistant Secretary to work in consultation with qualified experts to provide information on methods of improving indoor air quality in buildings where seniors congregate.

(Sec. 30) Amends the National Family Caregiver Support Act to include within the definition of "child" an individual who has a disability. Expands the definition of "family caregiver" to include an informal provider of in-home and community care to individuals with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction. Decreases the specified age for a "grandparent or older individual who is a relative caregiver" to 55.

(Sec. 31) Includes in area agency on aging services providing assistance to caregivers in addressing issues related to health, nutrition, and financial literacy and in making decisions and solving problems related to their caregiving roles.

Requires the state, in providing services for family caregivers, to give priority for care to older individuals.

Requires each area agency to encourage the use of trained volunteers to expand available services and to coordinate with volunteer programs to provide training, placement, and stipends for volunteers in community services settings.

Requires the reports submitted by a state to the Assistant Secretary to include descriptions of any mechanisms used to provide family caregivers of an older individual and relative caregivers of a child or an adult with disability information about, and access to, services to better carry out their responsibilities.

(Sec. 32) Authorizes (current law requires) the Assistant Secretary to carry out programs of national significance to improve support to caregivers of older individuals through activities that include: (1) multigenerational programs; (2) supportive programs for a child with a disability or chronic illness and for families in need; (3) programs for rural caregivers; (4) programs for older individuals with Alzheimer's disease; and (5) programs for caregivers that carry out health promotion and disease prevention.

(Sec. 33) Authorizes the Assistant Secretary to make grants for: (1) planning activities to prepare communities for the aging of the population; and (2) developing, implementing, and assessing technology-based service models and best practices to support the use of health monitoring and assessment technology, communication devices, assistive technologies, and other technologies that may remotely connect family and professional caregivers to frail elderly residing in home and community-based settings or rural areas.

(Sec. 34) Includes Hispanic serving institutions among institutions of higher education to which the Assistant Secretary shall make grants for career preparation for the field of aging.

(Sec. 35) Includes mental health care services among the services that receive support from the grant program for health care service demonstration projects in rural areas.

(Sec. 36) Authorizes the Secretary to award grants for demonstration projects that improve transportation services for older individuals. Defines "economically sustainable transportation" to mean demand responsive transportation for older individuals that: (1) may be provided through volunteers; and (2) is provided without public financial assistance after not more than five years.

(Sec. 37) Authorizes the Secretary to establish a national technical assistance program to assist states and area agencies on aging funded under this Act in planning efforts to prepare communities for the aging of the population.

(Sec 38) Requires (current law authorizes) the Secretary to award grants to establish demonstration projects to: (1) conduct research to determine the effectiveness of engaging older individuals in positions with public and nonprofit organizations; (2) develop a national agenda and blueprint for creating such positions to increase the capacity of the organizations to provide needed community services; (3) carry out demonstration and support projects to provide older individuals with multigenerational and civic engagement activities; and (4) carry out demonstration projects to coordinate such activities. Requires the Assistant Secretary, in awarding grants, to give preference to specified organizations. Provides eligibility requirements for organizations to receive grants. Requires the Assistant Secretary to report to Congress on the effectiveness of such activities.

(Sec. 39) Includes mental health care as a priority area of concern for the Resource Centers on Native American Elders for Native American programs.

(Sec. 40) Requires the Assistant Secretary to make competitive grants to states for the development and operation of delivery systems for mental health screening and treatment services and related programs for older individuals who lack access to such services. Requires such programs to: (1) increase public awareness regarding the benefits of prevention and treatment of mental disorders in older individuals; (2) reduce the stigma associated with mental disorders in older individuals and other barriers to the diagnosis and treatment of the disorders; and (3) reduce age-related prejudice and discrimination regarding mental disorders in older individuals.

Requires a state agency that receives a grant to: (1) allocate grant funds to area agencies on aging to carry out multidisciplinary health services; (2) give priority, in allocating the funds, to planning and service areas that are medically underserved and in which there are a large number of older individuals. Requires each area agency on aging to coordinate mental health and treatment services with other organizations and integrate outreach and educational activities with existing health care and social service providers.

(Sec. 41) Authorizes the Assistant Secretary to make grants to enable entities to develop model aging in place projects. Requires recipients to use the funds to provide and coordinate services that include a comprehensive and coordinated array of community-based health and social services. Requires such entities to serve communities of low-income individuals and to operate or locate projects in locations where large concentrations of older individuals reside.

Requires the Assistant Secretary to award competitive grants to experienced nonprofit organizations to provide technical assistance to aging in place grant recipients.

Requires the Assistant Secretary to report annually to Congress on: (1) the evaluation of aging in place model projects; (2) best practices for carrying out projects for older individuals aging in place; and (3) recommendations for legislative or administrative actions.

(Sec. 42) Requires the Assistant Secretary to make competitive grants to enable states to pay for the federal share of the cost of modifying their long-term care systems to promote and facilitate: (1) the choice and control of older individuals and their families in securing long-term care; (2) the coordination and cost-effectiveness of state long-term care systems; (3) the provision of long-term care; and (4) the ability of individuals receiving long-term care to remain as independent and self-sufficient as possible.

Requires that states use funds to carry out demonstration projects by integrating public education efforts, Healthy Lifestyle Choices programs, Aging and Disability Resource Centers (ADRC), and Community Living Incentives programs into their systems of long-term care. Requires states to conduct public education activities to ensure that consumers are aware of long-term care issues.

Requires states to provide for community-level ADRCs, which are required to provide: (1) comprehensive information on available public and private long-term care programs, options, and resources; (2) personal counseling and service coordination to assist consumers in assessing their long-term care needs and circumstances and in developing and implementing a plan for such care; (3) a convenient point of entry to publicly supported long-term care programs for which an individual may be eligible; (4) a single process for consumer intake, assessment, and applications for benefits programs; (5) the ability to respond immediately to a request for assistance in a crisis situation that could result in placement in an institutional care setting; and (6) to provide such assistance to temporarily preclude the need for such placement.

Requires states to ensure that the ADRC staffs are trained to understand the interactions between private long-term care insurance and eligibility for Medicaid benefits.

Requires states to: (1) provide for low-cost, community-level, evidence-based prevention programs and related tools to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; (2) provide funding toward the provision of long-term care to individuals at high risk for institutional placement; (3) ensure that individuals at greatest risk for becoming eligible for benefits under the Medicaid program receive priority for long-term care; (4) assess the needs and preferences of high-risk individuals with respect to long-term care and to develop plans for such care; (5) ensure that funding for Community Living Incentives programs be allocated among, and disbursed for, the budgets of high-risk individuals under long-term care plans; and (6) provide high-risk individuals with the option to receive long-term care in a manner that permits individuals to direct and control, in conjunction with a service coordinator, the selection, planning, budgeting, and purchasing of such care.

Sets the federal share for the cost of demonstration projects at not more than 75%.

Requires states to ensure that ADRCs: (1) coordinate their activities with any state health insurance information, counseling, and assistance program receiving funding; (2) are subject to controls to ensure there is not a conflict of interest with respect to any referrals made by the ADRC for individuals' receiving services; and (3) provide no long-term care services or supplies, with the exception of case management services provided through the area agencies on aging.

Excludes payments made for high-risk individuals from an individual's gross income for the purposes of the Internal Revenue Code of 1986 and for purposes of determining the individual's eligibility or cost-sharing for any other federal or state program.

Requires the Assistant Secretary to provide for: (1) technical assistance and oversight of states carrying out demonstration projects for the purpose of administration, quality assurance, and quality improvement; and (2) an evaluation of the demonstration projects and a report to the President.

(Sec. 44) States that an underemployed person is considered to be an unemployed person. Requires older American community service employment projects to serve the needs of eligible individuals with limited English proficiency. Limits participation in the Older American Community Service Employment Program to no more than 36 months in the aggregate. Allows Program grantees to extend the period of participation for no more than 20% of the project participants. Requires the grantee, in selecting participants for such extended period, to give priority to participants age 65 and older, frail older individuals, and individuals who have specified barriers to employment.

Authorizes grantees to petition for a waiver of the 36-month limit if the grantee serves a high concentration of individuals who are hard-to-serve because they have more than one specified barrier to employment.

Expresses the sense of the Senate that: (1) the Program was created with the intent of placing older individuals in community service positions to provide job training placements; and (2) placing older individuals in such positions strengthens the ability of individuals to become self-sufficient, provides volunteer support to organizations that benefit from increased civic engagement, and strengthens the communities served.

Requires the Secretary of Labor to consult with the Assistant Secretary regarding establishing and implementing performance measures for grantees.. Includes among factors for which the levels of performance (applicable to performance indicators) may be adjusted: (1) not less than 60% of counties in areas served by grantees are rural; and (2) the areas served by the grantee comprise a difficult-to-serve territory due to limited economies of scale.

Eliminates the requirement that grants be awarded for a period of a year by requiring the Secretary to award grants to carry out projects for a four-year period through a competitive process that emphasizes meeting performance measures.

Stipulates than an applicant is eligible to receive a grant according to criteria in current law. Adds the following as criteria for grantee selection: (1) the applicant's performance and the applicant's ability to meet the required indicators; and (2) the applicant's ability to administer a program that provides community service and to minimize disruption in services for participants and employers.

Repeals provisions concerning corrective action for a grantee's failure to meet performance standards and instead requires the Secretary to provide technical assistance to the grantee.

Adds the following groups to the definition of individuals with barriers to employment: minority and Indian individuals, individuals with limited English proficiency, and individuals with greatest economic need. Requires a national grant recipient, in selecting subgrantees in areas where a substantial population of individuals with barriers to employment exists, to give special consideration to selecting organizations with demonstrated expertise in serving individuals with barriers to employment.

Prohibits the Secretary from promulgating rules affecting grantees in areas where a substantial population of minority individuals exists that would significantly compromise the ability of grantees to serve their targeted populations.

(Sec. 47) Prohibits the Secretary, for purposes of determining income eligibility under the program, from including as income: unemployment compensation, specified benefits received under the Social Security Act, and payments made to or on behalf of veterans or former members of the Armed Forces under laws administered by the Secretary of Veterans Affairs, or 25% of the old-age and survivors insurance benefits under the Social Security Act.

(Sec. 49) Authorizes appropriations for: (1) the Native American Caregiver Support Program; (2) vulnerable elder rights protection activities; and (3) eligible Native American entity elder rights activities.

(Sec. 51) Requires state agencies to use allotments for programs for the prevention of elder abuse, neglect, and exploitation to provide for public education and outreach to promote financial literacy and prevent identity theft and financial exploitation.

(Sec. 53) Establishes as purposes of the Elder Justice Programs: (1) to assist states and Indian tribes in developing a comprehensive multidisciplinary approach to elder justice; (2) to promote research and data collection that will fill gaps in knowledge about elder abuse, neglect, and exploitation (abuse); (3) to support activities of service providers and programs that are designed to address issues relating to such abuse; (4) to assist states, tribes, and local service providers in the development of strategic plans for the development and coordination of elder justice research, programs, studies, and training; and (5) to promote collaborative efforts and diminish overlap and gaps in efforts in developing the important field of elder justice.

Authorizes the Assistant Secretary to award grants to states and tribes to strengthen long-term care and provide assistance for elder justice programs.

Authorizes a state or tribe that receives a grant to use the funds to award grants to eligible entities: (1) for the prevention, detection, assessment, and treatment of, intervention in, investigation of, and response to abuse; (2) to examine various types of elder shelters and to test models for establishing such shelters; (3) to establish or continue volunteer programs that focus on the issues of abuse or to provide related services; (4) to support multidisciplinary elder justice activities; (5) to provide training for individuals with respect to abuse issues; (6) to address underserved populations of elders; (7) to provide incentives for individuals to train for, seek, and maintain employment providing direct care in a long-term care facility; (8) to encourage the establishment of partnerships to develop approaches to improve the quality of long-term care; and (9) to establish multidisciplinary panels to develop best practices concerning methods of improving the quality of long-term care and addressing abuse.

Requires the Assistant Secretary to develop accountability measures and to evaluate program activities.

Authorizes funds for FY2005-FY2008 to carry out grants authorized to states and tribes to strengthen long-term care and provide assistance for elder justice programs.

Provides for the uniform collection of national data on elder abuse, neglect, and exploitation. Requires the Secretary to report to Congress on such collection.